增加有价值的行为先于减少痛苦：使用 ACT 的随机对照试验结果。

Increasing valued behaviors precedes reduction in suffering: Findings from a randomized controlled trial using ACT.

机构信息

University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Missionsstrasse 62A, CH-4055 Basel, Switzerland; Technische Universität Dresden, Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Chemnitzer Straße 46, 01187 Dresden, Germany.

German Rheumatism Research Centre Berlin, Leibniz Institute, Epidemiology Unit, Charitéplatz 1, 10117 Berlin, Germany; Charité Universitätsmedizin Berlin; Institute for Social Medicine, Epidemiology and Health Economics, Luisenstraße 57, 10117 Berlin, Germany.

出版信息

Behav Res Ther. 2017 Apr;91:64-71. doi: 10.1016/j.brat.2017.01.013. Epub 2017 Jan 24.

DOI:10.1016/j.brat.2017.01.013

PMID:28160720

Abstract

BACKGROUND

Psychological flexibility theory (PFT) suggests three key processes of change: increases in value-directed behaviors, reduction in struggle with symptoms, and reduction in suffering. We hypothesized that Acceptance and Commitment Therapy (ACT) would change these processes and that increases in valued action and decreases in struggle would precede change in suffering.

METHOD

Data were derived from a randomized clinical trial testing ACT (vs. waitlist) for treatment-resistant patients with primary panic disorder with/without agoraphobia (n = 41). Valued behavior, struggle, and suffering were assessed at each of eight sessions.

RESULTS

Valued actions, struggle, and suffering all changed over the course of therapy. Overall changes in struggle and suffering were interdependent whereas changes in valued behavior were largely independent. Levels of valued behaviors influenced subsequent suffering, but the other two variables did not influence subsequent levels of valued action.

DISCUSSION

This finding supports a central tenet of PFT that increased (re-)engagement in valued behaviors precedes reductions in suffering. Possible implications for a better understanding of response and non-response to psychotherapy are discussed.

摘要